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Joined: Jan 2017
Posts: 4,727
10 point
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10 point
Joined: Jan 2017
Posts: 4,727 |
Insurance companies have a negotiated amount they will allow their customers to pay for a certain medicine if they get their prescription filled at an in-network pharmacy. This amount is negotiated by the PBM's. A pharmacy/pharmacist does not have to be an in-network provider for any insurance companies. Same goes for doctors, etc.
But you may not have many customers if you are not in-network with several insurance plans. If you agree to be an in-network pharmacy, then you have agreed to their reimbursement rates. So if the rates are not acceptable, then they should stop being an in-network provider.
This is how I understand it, but if I have any or all of it wrong please correct me.
"It is the mark of an educated mind to be able to entertain a thought without accepting it"
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